15930 SW QUEEN VICTORIA PLACE cO
15930 SW QUEEN VICTORIA PL
BUILDING PEPMIT
CITY
OF TIGAR®
PERMIT#: BUP2001-00303
DEVELOPMENT SERVICES DATE ISSUED: 8/23/01
13125 SW Hall Blvd., Tigard, OR 97223 (303) 639-4171 PARCEL: 2S11013C-08000
SITE ADDRESS: 15930 SW OUFEN VICTORIA PL
SUBDIVISION: KING CITY NO.3 ZONING:
BLOCK: LOT: 054 JURISDICTION- KIN
REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION _
CLASS OF WORK: OTR FIRST: sf N: ^� S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: VV:
OCCUPANCY GRP: R3 TOTAL AREA: 0 O0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SED RATED.
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: F;EQ_ D SETBACKS_Y _ REQUIRED___ _!
FLOOR LOAD: psf _EFT ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 5,800.00
Remarks: Remove existing roof and replace with PABCO 25 year.
Owner: Contractor:
COSTANZO, CARL MARIE M UNITED ROCFING + CONSTRUCTION
15930 SW QUEEN VICTOPIA PL 7276 SW BEAVERTON-HILLSDALE HW
TIGARD, OR 97223 STE 199
Phone: Pqffone:TLAND, OR 97225
Reg#: LIC 00091955
r FEES REQUIRED INSPECTIONS -------
Type By Date Amount Receipt Dryrot After Tear-Off Insp
PRMT CTR 8/23/01 $100.90 "7200100000 Final Inspection
5PCT CTR 8/23/01 $8.07 27200100000
Total $108.97
I '
--This permit is issued subject to the regulations contained in the Tigard Municipal Codes, State of OR, Specialty Codes
and all other applicable law. All work will be done in accordance with apps oved plans. This permit will expire if work is
not started within 180 days of issuance, or if wor..: is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Orego s Utility Notification Center. Tho;:e rules are set forth in OAR
952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503)246-6699 or 1-800-332-2344.
Pe rm ittee 4 ,
Signature:
j,
Issued By: i_` 1 G (� Jtl >
T
Call 639-4175 by 7 p.m. for an inspection the next business day
Building Peri nit Application
'•_ — � — Date received: Permit no.:
City of "Tigard
Address: 13125 SW Hall Blvd,Tigard,OR 97223 RojecUappl.no.: Expire date:
City of Tigard
Phone: (503) 6394171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land Use approval; _ _ -_- 1&2 family:simple Complex:
TYPE OF-PERM IT
0 1 &2 family dwelling nr accessory U Commercial/industrial U Multi-family U New construction U Demolition
U Add ition/al teration/mplact:ment U Tenant improvement Ll Fire sprinkler/alarm U Other: -
JW,�5111 SITE INFORMAtION
Job addres: /Jr 30 >�7 �,Ckjl21A Iildt;.nu.: Swtc no.:
--------- -
Lot: Black: Su n: Tax map/tax lot/account no..
Project name: _��
Description and location of work on prernises/special conditions:L7E_7
1 1 1
Name: lQ JCC
Mailing address:/ I &2 family G selling:
State 7.1P: Valuation of work........
City: r� ............................... t,
Phone: —.(q3 Fax: E-mail: No.ofbedrooms/baths.................................
Owner's representative: Total number of floors.................................
— ----- ----
Phone: Irax 1. mail. New dwelling area(sq.fl.) _
Or carport arca(sq.ft.).........................
I I porch area(sq.ft.) ......................... --
Name: —
Mailing address: -- Dei. area(sq. fl.) .......................................
City: _ — State: ZIP: Odier structure_area(sq.ft.).........................
Phone: -____TFax: E-mail- CommereinUimdustrial/multi-family:
Valuation of work........................................ Si
`?
Existing bldg.arca(sq.ft.) ..............
Business name:(,( Q���t W ............
Address: - New bldg.area(sq.ft.)................................
City� State' ZIP: � 3 Number of stories........................................
Phone: Z Fax: E-mail: Type of construction....................................
CCB no.: c I Qs� Occupancy group(s): Existing: — _-
- — New:
City/metro I c.no.: '2 Notice:All contractors and subcontractors are required to be
t licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed it. the
Address: — --� jurisdiction where work is being performed. If the applicant is
!'it State: ZIP: exempt from licensing.the follgwinp reason applies:
Contact person: _ Plan no.: _ _ — — --`--'-- —
Nltone: — Fix F,-mail
Name: _ t ni:,t I,(1"oil. _ Fecs due upon application ........ . ............. i ---_--------
Address: Date received:
City: State: Amount received ......................................... $
Phone: Fax: E-moa: — Please refer to fee schedule.
1 hereby certify l have read and examined this application and the No dl iuriKk&m accet,h cmW cards pkax call judulichion for mac inrarnWloo
attached checklist.All provisions of laws and ordinances governing this U visa U MasterCard
work will be compli with,whethgr.. cified herein or no. Cmdth urd number:-- — _
n.,,J-, SNL fl B ( - -— :apircs
Authorized signatu I Data Name of cardn�ide,u snorm on cmdn cae
Print name:0 AJU I - — _ —
Czd6—T N jnume Amount
Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. worau(rYt ACOM)
.I
RE-ROOFING PERMIT CHECK LIST ,
r
FtSIDE_NTIAL ONLY - Class of Work- Alteration
REPAIR(MAJOR) (plan review required by plans examiner)
3uilding permit is required when spaced Sheathing is covered by solid sheathing and/or
changes are made to roof line.
SUBMIT TWO (2)SETS OF PLANS SPECIFYING.-
A.
PECIFYING:A. Roof area and nearest street.
B. Attic vents: Provide 1 sq. ft. for each 150 sq. ft. of attic space. Vents shall be located in
the upper 1/3 of the roof. Prcvide 1 sq. ft. for each 300 sq. ft. when eave and attic
venting is provided.
hLqte: No permit is required for residential re-roof if, (1) not more than three layers of
roofing will exist upon completion of the re-roofing or, (2)sheathing is not being applied over
spaced she-thing (spaced sheathing usually exists when wood shingles were initially
applied)
COMMERCIAL ONLY - Class of Work: Repair
STEP 1: _
U_ RE-ROOF (circle A, B or C):
A. Existing built-up roof covering to be REMOVED and deck repaired.
B. Existing built-tip roof covering to REMAIN. Note: Applicant must submit an engineer's
review of the roof structural elements Review shall bear the seal (or stamp)of the
architect or engineer licensed in Oregon.
C. Asphalt or wood shingle/shake. (PROCEED TO STEP 2) _—
COMMERCIAL ONLY - Class of Work: Repair
STEP 2: NEW ROOFING ASSEMBLY
Material Documentation (UBC Appendix �—
Please fill out applicable section and attach copy of roofing specifications.
_Listed Assembly (Circle and complete A, B or C): _
A. 1. Specification#: _
`Z � A 2. Manufacturer:_
3a. UL Classification:
Linted UL Building Materials Directory Page#: —
OR
3b. Warnock Hersey:_
Listed Warnock Hersey Directory Page#: _— —
'COPY OF ASSEMBLY REQUIRED
B. ICBO Research #:
Dated:
C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
Review required by plans examiner.)_ ^— —_—
VALUATION OF PROJECT: oo ---- -- ----
sq. ft. of roof area .5160
Permit Fee based on valuation:
--------------------
$
see BuildingPermit Fees chart)
8%,o State Surcharge: $ }
_ _ ---- —_
65% Plan Review Fee:
(Required for major repairs of Residential or
Assembl jtem"C',above_
TOTAL:
I:dsts\forms\roofchocklist.d 10/05/00